In Australia, the use and possession of non-medicinal cannabis remain illegal in most states and territories. However, patients with specific medical conditions may be eligible for medicinal cannabis under strict regulations. The Therapeutic Goods Administration (TGA) oversees prescribing, allowing access only when conventional treatments have failed or caused intolerable side effects. To prescribe medicinal cannabis, healthcare providers must navigate regulatory pathways such as the Special Access Scheme (SAS) or obtain Authorised Prescriber status, as most cannabis-based products are not registered on the Australian Register of Therapeutic Goods (ARTG).

Cannabis Usage in Australia

Medical cannabis usage in Australia is skyrocketing.

• In 2019, there were 28,000 cannabis prescription approvals
• In 2021, there were over 70,000 SAS-B prescriptions approved
• In 2022, there were around 326,000 SAS-B prescriptions approved

Today it is estimated that roughly 2.7% of the population (of ~30 million) is using legally prescribed medicinal cannabis products¹.

Who can be prescribed cannabis in Australia?

Medicinal cannabis may be prescribed for conditions such as

• Cancer pain and/or symptoms.
• To relieve vomiting resulting from chemotherapy (a cancer treatment).
• Severe epilepsy (seizures).
• Treating muscle spasticity and pain in Multiple Sclerosis.
• Pain caused by nervous system damage.
• Palliative care – to relieve pain or symptoms related to a terminal illness.

Prescribing decisions must consider patient-specific factors, including potential contraindications like age, psychiatric disorders, cardiovascular conditions, and pregnancy. Ongoing patient monitoring, informed consent, and compliance with state and territory regulations are essential components of the prescribing process.

Online Prescribing Algorithms

Online prescribing of cannabis varies considerably among different providers. Below is a summary of the main points…

Step 1: Pre-Screen Patient Eligibility Assessment

This stage is conducted before a prescriber is consulted. It is intended to exclude high-risk and contraindicated patients. Steps within this stage include:

• Checking patient identification (KYC) and obtaining informed consent
• Confirming the patient has a diagnosed medical condition with symptoms potentially alleviated by medicinal cannabis (e.g., chronic pain, epilepsy, multiple sclerosis, chemotherapy-induced nausea).
• Screen the patient’s history of substance use and mental health conditions and conduct a mental health screening (e.g., DASS-21 or Kessler K10) if indicated.
• Ensure the patient has tried conventional therapies and found them ineffective or with intolerable side effects.
• Exclude patients with:
  • Age under 25 yo.
  • History or family history of psychosis, schizophrenia, or bipolar disorder.
  • Current or past cannabis use disorder (CUD), those recovering from alcoholism, opioid dependence, or other drug addictions may be at a higher risk.
  • Uncontrolled cardiovascular conditions (e.g., hypertension, arrhythmias, angina or a history of myocardial infarction).
  • Pregnant, planning pregnancy, or breastfeeding.
  • Narrow therapeutic window medication (unless blood monitoring is possible)

Step 2: Risk Assessment

Additional risk factors include:

• Taking an enzyme inducer / inhibitor / substrate

Double check:

1. Precautions and contraindication
2. Screen for interactions
3. Consider the safety of the route of administration
4. Consider the safety of chemovars (strain)

Step 3: Treatment Plan

• The prescriber selects a specific cannabis formulation (THC, CBD, or combination) based on symptoms and condition.
• This usually entails starting with the lowest effective dose (beginning with THC doses <10 mg) and titrating upward as needed.

Step 4: Regulatory Compliance

• The prescriber documents the consultation and discusses potential benefits, risks, and legal considerations.

Step 5: Monitoring and Review

• Schedule follow-up appointments to monitor efficacy, side effects, and adherence.
• Use validated tools to track symptom changes and side effects.

References

¹ Medical cannabis treating at least 2.7 percent of population (no date) The University of Sydney. Available at: https://www.sydney.edu.au/news-opinion/news/2022/12/16/medical-cannabis-treating-population.html (Accessed: 13 February 2025).

² MacCallum CA, Lo LA, Boivin M. “Is medical cannabis safe for my patients?” A practical review of cannabis safety considerations. European Journal of Internal Medicine. 2021;89:10-18. doi:https://doi.org/10.1016/j.ejim.2021.05.002

‌

Ibogaine, a psychoactive indole alkaloid found in the West African shrub Tabernanthe iboga, has gained recognition for its potential in treating substance use disorders (SUDs). It has a historical background in Western medicine, initially used as a neuromuscular stimulant and later for its unique properties in attenuating cravings and withdrawal symptoms in addiction cases.

The scientific research on ibogaine provides insights into its potential effectiveness and safety concerns in treating drug dependence. Here are key findings from various studies:

1. Efficacy in Treating Drug Dependence: A retrospective study in Brazil found that ibogaine treatment, combined with psychotherapy, led to abstinence in 61% of participants, with no serious adverse reactions or fatalities reported. Those treated multiple times showed a statistically significant increase in abstinence duration compared to single treatments (Schenberg et al., 2014).
2. Animal Model Efficacy: A systematic review and meta-analysis of animal studies concluded that ibogaine reduced drug self-administration, especially within the first 24 hours after administration. However, it also caused motor impairment and cerebral cell loss (Belgers et al., 2016).
3. Transitioning to Sobriety: Clinical observations and treatment outcomes suggest that ibogaine may effectively transition opioid and cocaine-dependent individuals to sobriety. This conclusion is based on public testimonials and preclinical studies, although rigorous validation in humans is needed (Mash et al., 2018).
4. Potential Safety Concerns: The relationship between ibogaine and heart health is delicate, with alarming reports of life-threatening complications and sudden deaths associated with its use. These adverse reactions are thought to be linked to ibogaine’s tendency to induce cardiac arrhythmias (Koenig & Hilber, 2015).
5. Cardiac Risks and Safety in Detoxification: A descriptive open-label observational study on the safety of ibogaine in opioid-dependent individuals showed clinically relevant but reversible QTc prolongation, bradycardia, and severe ataxia. This highlights the importance of close monitoring during treatment (Knuijver et al., 2021).
6. Systematic Review of Ibogaine/Noribogaine: A systematic review assessing the role of ibogaine and noribogaine in treating substance use disorders (SUD) highlighted some efficacy but also raised concerns about cardiotoxicity and mortality, underscoring the need for further research to evaluate their therapeutic efficacy and safety (Mosca et al., 2022).

Ibogaine in Australia

Ibogaine has received considerable scrutiny in Australian media, largely due to concerns over its potential cardiotoxicity. However, when you look at the scientific research, ibogaine shows a more favorable mortality profile compared to methadone—a widely used treatment for opioid addiction. Despite this, ibogaine is classified as a Schedule 9 substance under the Therapeutic Goods Administration’s Poisons Standard, meaning it is prohibited in Australia. Possession, use, sale, or importation is illegal without a specific research exemption or special authorization. While there are currently no legally operating ibogaine clinics in Australia, just a two-hour flight from Sydney to New Zealand opens the door to a different medical jurisdiction—where ibogaine treatment is accessible and medical tourism begins.

The New Zealand Experience
In New Zealand, ibogaine has drawn growing attention, particularly following 2010 legislative changes that permitted its use as a non-approved prescription medicine for therapeutic purposes. Since then, the country has emerged as a global leader in the responsible and medically supervised use of ibogaine to treat opioid dependence.

One notable study conducted in New Zealand and assessed the impact of a single ibogaine treatment on individuals struggling with opioid addiction¹. Over a 12-month period, participants reported significant reductions in withdrawal symptoms and, in many cases, either complete cessation or a sustained decrease in opioid use.

The New Zealand Model of Ibogaine Therapy

Ibogaine treatment in New Zealand typically follows a structured and medically supervised approach that includes several distinct phases:

1. Pre-Treatment Assessment

Before undergoing therapy, each patient receives a comprehensive medical evaluation. This includes a review of medical history, current health status, and identification of any potential contraindications to ensure that the individual is a safe candidate for ibogaine.

2. Personalized Treatment Planning

Based on the initial assessment, clinicians develop a tailored treatment plan that aligns with the patient’s specific needs, health status, and recovery goals.

3. Ibogaine Administration

Ibogaine is administered in a controlled clinical setting under the supervision of licensed medical professionals. The treatment environment is designed to be safe, calm, and supportive, with continuous monitoring of vital signs throughout the session.
Treatment typically spans 12 to 24 hours, with peak psychoactive effects occurring within the first 4 to 8 hours.

Phases of an Ibogaine Session

1. Onset Phase (1–3 hours):
   Effects begin 1–2 hours post-ingestion, often including visual imagery, physical sensations, and a heightened state of introspection.
2. Acute Phase (4–8 hours):
   The most intense period, marked by vivid visions, emotional processing, and deep introspective experiences. Patients are usually in a restful state, eyes closed, in a quiet setting.
3. Evaluative Phase (8–12 hours):
   Visual effects begin to fade, but mental clarity increases. This is a period of reflection, where users often process traumas, behaviors, and patterns linked to their addiction.
4. Residual/Stabilization Phase (12–24+ hours):
   As the drug’s effects taper, patients begin physical recovery. Some may experience residual stimulation, sleeplessness, or emotional sensitivity. Medical staff remain on hand to support and monitor well-being.

4. Post-Treatment Integration and Aftercare

Following the session, patients receive continued support to help integrate their experiences into long-term behavioral change. This often includes:

• Psychological counseling
• Lifestyle and wellness planning
• Strategies for sustained sobriety
• Referrals to additional support services if needed

Conclusion

The New Zealand model for ibogaine therapy offers a unique blend of medical oversight, psychological support, and personal transformation. Backed by observational studies and real-world outcomes, it continues to pave the way for innovative, holistic approaches to tackling opioid addiction.

If you’re interested in staying informed about developments in psychedelic medicine and future opportunities to engage with an open-minded community, consider joining The Transparent Company mailing list. We’d love to share this journey with you.

References

¹ Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study. The American Journal of Drug and Alcohol Abuse. Published online 2018. doi:https://doi.org/10.1080//00952990.2017.1310218

MDMA-assisted therapy has shown significant promise in the treatment of various psychiatric disorders, including post-traumatic stress disorder (PTSD), depression, and anxiety. This article provides an overview of the best practices in MDMA-assisted therapy, synthesized from recent scientific research.

Introduction

MDMA, commonly known as ecstasy, when used in a controlled therapeutic setting, has been shown to enhance the effectiveness of psychotherapy for certain mental health conditions.

Best Practices in MDMA-Assisted Therapy

1. Therapeutic Setting: MDMA is administered in a controlled clinical setting, often accompanied by psychotherapy sessions. This combination is critical for achieving the desired therapeutic outcomes (Yazar‐Klosinski & Mithoefer, 2017).
2. Dosage and Administration: Clinical trials have experimented with different dosages to find the optimal amount for therapeutic use. Typically, MDMA is administered in a single dose during therapy sessions (Oehen, Traber, Widmer, & Schnyder, 2013).
3. Safety and Tolerability: Research indicates that MDMA can be safely administered in a clinical setting, with no significant drug-related serious adverse events (Feduccia & Mithoefer, 2018).
4. Efficacy: Studies have shown that MDMA-assisted psychotherapy can lead to clinically significant improvements in PTSD symptoms and potentially other disorders (Smith, Sicignano, Hernández, & White, 2021).
5. Extended Benefits: MDMA catalyzes shifts toward openness and introspection that can result in lasting benefits without the need for ongoing administration (Danforth, Struble, Yazar-Klosinski, & Grob, 2016).
6. Patient Diversity: Recent trials indicate the efficacy of MDMA therapy across a diverse range of patients, including those with severe PTSD and other comorbidities (Mitchell et al., 2021).
7. Mechanism of Action: MDMA enhances the release of neurotransmitters and hormones that modulate emotional memory circuits, aiding in the reprocessing of traumatic memories and facilitating fear extinction (Feduccia & Mithoefer, 2018).

Conclusion

MDMA-assisted therapy represents a breakthrough in the treatment of certain psychiatric disorders, offering a unique combination of pharmacological and psychotherapeutic interventions. The controlled use of MDMA in therapeutic settings has shown significant efficacy and safety, making it a promising option for patients who are resistant to traditional treatments.

The information presented in this article is based on current scientific research and is subject to change as new studies emerge. Always consult with a healthcare professional for medical advice and treatment.

There has been a recent increase in interest in MDMA therapy as Lykos Therapeutics intends to launch MDMA as a licensed medicine towards the end of 2024. This marks a significant milestone in the evolving landscape of psychedelic-assisted therapy, particularly for conditions like post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD).

MDMA-assisted psychotherapy represents a novel approach to mental health treatment. Its efficacy primarily revolves around its ability to enhance the therapeutic process by fostering a sense of openness, empathy, and reduced fear response during psychotherapy sessions. This environment is conducive for patients to process and integrate challenging emotions and memories, particularly those related to traumatic experiences.

The safety and tolerability of MDMA therapy have been major points of consideration. Recent studies indicate that when administered in a controlled clinical setting, MDMA treatment is well-tolerated by participants. Adverse events have been rare and non-life-threatening, emphasizing the controlled use of MDMA in clinical environments as a key factor for safety. Research shows that MDMA therapy for PTSD is entering the final phase of drug development, with an aim for FDA and EMA licensing in the near future. This progress indicates the potential for MDMA to become a medicine, assuming clinical efficacy criteria are achieved (Sessa, Higbed, & Nutt, 2019).

Further, MDMA-assisted therapy has shown promising results in treating social anxiety in autistic adults and anxiety associated with life-threatening illnesses. Unlike conventional drug treatments, MDMA-assisted therapy is not intended for ongoing administration. It is used on one to several occasions within a psychotherapy protocol, potentially reducing the frequency of adverse events and improving the risk/benefit ratio. This aspect may present a significant advantage over medications that require daily dosing (Danforth, Struble, Yazar-Klosinski, & Grob, 2016).

As such, there are lots of ongoing clinical research on the subject, the most important of which include:

1. MDMA-Assisted Therapy for PTSD: A study analyzed brain activity and connectivity via functional MRI during both rest and autobiographical memory response before and two months after MDMA-assisted therapy in veterans and first responders with chronic PTSD. The study found reduced activation contrast after MDMA-assisted therapy in the cuneus and a correlation between recovery from PTSD and changes in functional connections during autobiographical memory recall (Singleton et al., 2023).
2. DNA Methylation and MDMA-Assisted Therapy: A pilot study suggested that DNA methylation of the glucocorticoid receptor gene is associated with treatment response in severe PTSD following MDMA-assisted therapy. The study examined epigenetic changes in key hypothalamic-pituitary-adrenal (HPA) axis genes before and after MDMA and placebo with therapy, finding significant methylation changes that may predict treatment response (Lewis et al., 2023).
3. Effects of MDMA-Assisted Therapy on Self-Experience in PTSD: Another study reported on the effects of MDMA-assisted therapy on patients with severe PTSD. It found that MDMA-assisted therapy, compared with psychotherapy alone, significantly altered domains of alexithymia, self-compassion, and altered self-capacities, suggesting substantial improvement in mental processes associated with poor treatment response (van der Kolk et al., 2023).

Other MDMA studies include:

Alongside this, there is a wide range of small investigator-led MDMA trials including:

• ICAN1: A Phase 2 Open-Label Treatment Development Study of MDMA-Assisted Psychotherapy in Conjunction with Cognitive Processing Therapy (CPT) for Chronic Posttraumatic Stress Disorder (PTSD)
• Influence of MDMA on Risk and Reward Circuits of the Brain
• MDMA-Assisted Psychotherapy for the Treatment of Social Anxiety Disorder
• Low-dose MDMA Versus Standard-dose MDMA in Therapy for Mood and Anxiety Symptoms in Advanced-stage Cancer Patients
• Feasibility Trial of MDMA-Assisted Psychotherapy for Depression
• Adjustment Disorder (AD) in Dyads (patient pairs) of Patients with Breast Cancer and a Concerned Significant Other

The development of MDMA-assisted psychotherapy heralds a new era in mental health treatment, promising a potentially transformative approach for patients with conditions resistant to current treatments. As Lykos Therapeutics prepares to introduce MDMA as a licensed medicine, the medical community and patients alike await with anticipation the outcomes and broader implications of this novel therapeutic approach.

In 6 months (around June 2024) the FDA (US medicine regulator) will likely approve MDMA (ecstasy) as a licensed medicine in the US. This will present a pivotal moment for mental health care around the world as the efficacy rates of MDMA relative to traditional treatments for PTSD, depression and addictions are impressive.

As you can see from above, the most recent data indicates high rates of remission from PTSD (red) with MDMA in comparison to placebo (blue). Further comparing these rates (see picture below) to traditional antidepressant effectiveness rates i.e. from 19 to 70% within SSRIs (Prozac et al.), from 31 to 70% within the SNRI (Duloxetine et al.) treatment arms, and from 23 to 54% within TCAs (Amitriptyline et al.).

This may not seem very impressive, however, there is one major distinction, MDMA is curative. The importance of this cannot be stressed enough. Aside from the cost of having to take traditional antidepressants every day which comes with a wide range of side effects, such as with, TCAs treatment: dry mouth (58%), sweating (28%) and constipation (26%)² there’s the additional burden of anhedonia (not being able to feel anything good, or bad!).

MDMA is different. The medicine treats the root cause of the disease instead of just tranquilising the symptoms such as poor mood or lack of motivation. MDMA does this through a process known as fear memory extinction, which modulates fear memory consolidation. At its simplest, this means MDMA can dissolve bad feelings associated with a memory which in extreme cases is termed trauma. This makes it more comparable to traditionally stronger, last-line treatments like ECT which has its major side effects of memory loss.

When will MDMA be available in Australia?

Well in theory, due to the changes put forth by the TGA on 1 July 2023, it should already be available. However, due to the huge amount of red tape and high demand, the vast majority of 1 in 7 depressed patients in Australia cannot get access. This is why the licensing by MAPS is so important, it puts the medicine in a licensed category meaning, that doctors will have better coverage by indemnity insurance if something were to go wrong, therefore, they will have a higher propensity to prescribe. i.e. the risk to them is a lot lower and therefore, given the demand this should cause an upsurge in supply.

So where to go from here? Stay updated with the latest developments. Whilst it’s likely the FDA will license the medicine in the US in June, it will take a bit of time to come to Australia (usually another 6 months). At this point, it is more than likely it will be considered a Controlled Drug and hopefully be prescribable by regular doctors (however this may be limited to psychiatrists only). By whichever route, it should be available this time next year, for a high price due to the overwhelming demand, this is why we have created the Psychedelic Buyers Club to ensure a lower cost via a bulk buy.

References

¹ MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Published in the Nature Medicine Journal: 10 May 2021: Jennifer M. Mitchell. Accessed on 2 January 2024 via: https://www.nature.com/articles/s41591-021-01336-3

² Tricyclic Antidepressants. Moraczewski J, Awosika AO, Aedma KK. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557791/

³ Remission, dropouts, and adverse drug reaction rates in major depressive disorder: a meta-analysis of head-to-head trials. Review published: 2006. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. M Machado, M Iskedjian, I Ruiz, and TR Einarson. https://www.ncbi.nlm.nih.gov/books/NBK73259/

As Australia continues to explore innovative treatments for treatment-resistant depression (TRD) and other mental health conditions, esketamine has emerged as a promising therapy. Delivered via nasal spray under the brand name Spravato®, esketamine is available at select approved clinics nationwide. However, due to regulatory controls, costs, and access limitations, many patients and clinicians are considering ketamine infusions or psychedelics such as psilocybin or empathogen MDMA as a more affordable and accessible alternative.

This article explores how esketamine clinics operate in Australia, the current landscape for patients seeking this treatment, and the emerging case for ketamine as a cost-effective alternative.

What Is Esketamine and How Is It Used in Australia?

Esketamine is a chemical mirror image (enantiomer) of ketamine, designed for intranasal use. Unlike traditional antidepressants that target serotonin or dopamine, esketamine works through the glutamate system, promoting neuroplasticity and providing rapid symptom relief—often within hours or days.

In Australia, esketamine (Spravato®):

• Is approved by the TGA (Therapeutic Goods Administration) for treatment-resistant depression in combination with oral antidepressants.
• Must be administered in a clinical setting due to the potential for dissociation, sedation, and blood pressure changes.
• Requires 2–3 sessions per week during the initial treatment phase, tapering to less frequent maintenance doses.

Treatment can only be administered at certified Spravato clinics with trained healthcare professionals on-site for at least two hours of post-dose monitoring.

The Cost Barrier of Esketamine Clinics

One of the biggest challenges facing patients is the high cost of esketamine therapy in Australia:

• A single session can cost between $700–$1,200 AUD, including monitoring fees.
• A full 6-8 week course may cost upwards of $8,000–$12,000 AUD.
• Spravato is not currently subsidised by the Pharmaceutical Benefits Scheme (PBS), meaning all costs are out-of-pocket.

Even with private health coverage, many patients find the cost prohibitive, especially when ongoing maintenance is required.

Ketamine Infusions: A More Accessible Option

In contrast, racemic ketamine—a mixture of two mirror-image molecules, including esketamine—is increasingly being used off-label in Australia for depression, PTSD, and chronic pain. Ketamine infusions:

• Are typically delivered intravenously (IV) or intramuscularly (IM) in specialist mental health or anaesthetic clinics.
• Have demonstrated comparable efficacy to esketamine in clinical research for depression and suicidal ideation.
• Cost between $300–$600 per session, depending on the clinic and location—often half the price of esketamine.

Although not formally approved by the TGA for mental health use, ketamine treatment is legal when prescribed by qualified practitioners under strict clinical protocols.

Comparing Esketamine and Ketamine

Barriers and Ethical Considerations

While ketamine may offer a more affordable path for many patients, it also presents challenges:

• Off-label use means more variability in protocols, dosing, and monitoring.
• Lack of long-term data compared to conventional antidepressants.
• Risk of recreational misuse or dependence without proper clinical supervision.

Still, for those who cannot afford esketamine or access a certified clinic, ketamine may be the only realistic option for relief from debilitating depression.

Conclusion

Esketamine represents a breakthrough in depression treatment, but its high cost and limited availability in Australia can put it out of reach for many patients. Ketamine infusions, though used off-label, offer a clinically sound and more accessible alternative when delivered responsibly.

As public awareness grows and the stigma around psychedelic therapies continues to shift, it’s likely that both esketamine and ketamine will play increasing roles in Australia’s mental health landscape—particularly if cost and access barriers are addressed.

If you would like us to help you find the right type of treatment, get in contact with one of our healthcare professionals using this form or join a public discussion group such as The Transparent Company.

Esketamine mechanism of action

The exact mechanism by which esketamine works to relieve depression symptoms is not fully understood, but it is thought to involve changes in brain chemistry and the activity of certain neurotransmitters.

One possible mechanism is that Esketamine works by inhibiting the reuptake of the neurotransmitter glutamate in the brain. Glutamate is involved in the regulation of mood and behavior, and inhibiting its reuptake leads to an increase in its concentration in the brain. This increase in glutamate is thought to be responsible for the rapid antidepressant effects of esketamine.

In addition to its effects on glutamate, esketamine is also believed to have an effect on other neurotransmitter systems in the brain, including dopamine and norepinephrine. It is not fully understood how these additional mechanisms contribute to the antidepressant effects of the drug.

The Role of Esketamine in a Comprehensive Depression Treatment Plan

Esketamine is typically reserved for patients who have not responded to other treatments for depression and is used on an as-needed basis in conjunction with regular therapy sessions. It is not intended to be used as a standalone treatment for depression, but rather as a part of a comprehensive treatment plan that may include other therapies such as cognitive-behavioral therapy, psychotherapy, and/or medication management.

The role of esketamine in a comprehensive depression treatment plan is to provide rapid symptom relief for patients who have not responded to other treatments. It is usually used in combination with other therapies in order to help patients achieve and maintain symptom improvement over the long-term. It is important for patients to work closely with their healthcare team to develop a treatment plan that is tailored to their specific needs and goals.

There are some exceptions to this rule, such as in the case of telemedicine, where a healthcare provider may prescribe controlled substances via a video call if certain conditions are met. However, the use of psychedelics for medical purposes is still highly regulated and not widely accepted.

One recent example of poor online prescribing practice is a story of a patient who was prescribed 75 doses of Ketamine in 5 minutes online which was then delivered to his house for under $300. Whilst providing access to low-cost medicine for patients is an ethical virtue of practice one should keep in mind that there is an online prescribing best practice which should be followed. This includes online prescribing risk analysis and subsequent mitigation which should be performed after each medicine is added to an online prescribing formulary.

However, if proper safeguards are in place there are a wide range of opportunities in the medical space, including:

• Psilocybin availability in the UK

If you would like more information concerning these opportunities you can contact one of our expert consultants here.

AMT
ALPHA-METHYLTRYPTAMINE
A designer drug that produces hallucinogenic effects paired with euphoria. Side effects can include vomiting and nausea.

Aya·hua·sca
BANISTERIOPSIS CAAPI
A powerfully psychedelic, traditionally used as a spiritual medicine in the indigenous Amazon. It contains a mixture of MAOI and DMT that allow the DMT to be orally active in the human body. Ayahuasca produces extremely intense visions and insights, combined with a form of purging. These effects are used as medicinal properties amongst the shamans of the Amazon.

Co·caine
BENZOYLMETHYLECGONINE
One of the most popular stimulants worldwide. It derived from the Erythroxylum coca plant and can produce stimulating and euphoric effects. Cocaine can also be highly addictive.

DMT
N,N-DIMETHYLTRYPTAMINE
A very strong psychedelic which is short-acting when being smoked, producing intense visions. Since it is produced in many plants, animals and the human body, it is not orally active. However, in combination with an MAOI, it is also part of the indigenous medicine Ayahuasca.

DXM
DEXTROMETHORPHAN HYDROBROMIDE
Used as a cough suppressant, DXM is a available over-the-counter. When taken in very high dosages, it produces strong dissociative effects, similar to Ketamine.

GBL
GAMMA BUTYRLACTONE
A precursor to GHB that produces very similar effects that come and go more rapidly. GBL is also acidic and has to be watered down if consumed as a drug. The effects and the side effects are more extreme than with GHB which makes it even more difficult to handle.

GHB
GAMMA-HYDROXYBUTYRATE
A GABA-based neurotransmitter that is part of the human central nervous system. It is used as a medication for instance to treat narcolepsy. Used as a drug, it produces short acting alcohol like intoxications that makes GHB popular as a party drug. Due to its sexual stimulating effects it is also very popular amongst MSM (Men who have sex with men) populations. GHB is very hard to dose and especially in combination with alcohol, it can lead to a long lasting coma-like state (‘G-sleep’) or even death. When used over long periods of time, it can also cause forms of psychological and physiological addiction.

Ha·wai·ian ba·by wood·rose
ARGYREIA NERVOSA
The seeds contain the psychedelic substance LSA.

Pir·ac·e·tam
2-OXO-1-PYRROLIDINEACETAMIDE
The first and still very popular ‚nootropic‘ or smart drug that is said to induce cognitive enhancement.

Mo·da·fi·nil
BENZHYDRYLSULPHINYLACETAMIDE
Originally a medication to treat narcolepsy, Modafinil is also used as a cognitive enhancement drug that is said to increase focus and wakefulness.

Mel·a·to·nin
N-[2-(5-METHOXY-1H-INDOL-3-YL)ETHYL]ACETAMIDE
Melatonin is a hormone produced by the pineal gland and involved in the regulation of sleep. It is used as a sleep aid and to help reset the body’s clock and help reduce jet-lag.

Morn·ing glo·ry
IPOMOEA VIOLACEA
A psychedelic plant that contains LSA, a naturally occurring relative of LSD. It has a long history of traditional use as a medicine amongst indigenous tribes in Mexico.

Ke·ta·mine
2-(2-CHLOROPHENYL)-2-(METHYLAMINO)-CYCLOHEXANONE
Ketamine is a dissociative drug that has a history in veterinary and human anaesthetics. In low dosages it produces ‘fluffy’ sensations which can transform into dissociation of the consciousness in higher dosages (‘K-Hole’). Ketamine is widely used as a party drug.

Kra·tom
MITRAGYNA SPECIOSA
It has a long history of use in Thailand and South East Asia. The leaves are chewed as an opiate substitute and stimulant, primarily among the working class.

Laugh·ing gas
NITROUS OXIDE
Nitrous Oxide is an anaesthetic that is also used in dentistry. It is also used as a whipped cream propellant which makes it highly available. Its effects are short lasting and dissociative, similar to DXM or Ketamine.

LSD
2-(2-CHLOROPHENYL)-2-(METHYLAMINO)-CYCLOHEXANONE
LSD is the best known and most researched psychedelic in the western sciences. Discovered in 1943 by Swiss biochemist Albert Hofmann, the substance produces pseudo-hallucinations, synesthesia and in higher dosages phenomena like ‘ego-death’ and mystical experiences.

MDMA
3,4-METHYLENEDIOXYMETHAMPHETAMINE; XTC
MDMA is one of the most popular synthetic drugs, especially in Western countries. It is either sold in crystalline form (‘Molly’, MDMA) or as the main ingredient in XTC (‘Ecstasy’) pills. It produces strong empathogenic, euphoric, and stimulant feelings. The emotional openness which it produces makes it popular in the electronic dance music scene but also interesting as a tool psychotherapy.

Mush·rooms
PSILOCYBE MUSHROOMS
Many species contain the psychedelic chemicals psilocybin or psilocin. They have a long history of use in Mexico and are currently one of the most popular and commonly available natural psychedelics. Their effects are very similar to LSD, including pseudo-hallucinations and profound insights or realizations.

Nut·meg
MYRISTICA FRAGRANS
Produces deliriant effects when used in large quantities. It has a history of use from the Arabian Peninsula to South East Asia.

Sal·via di·vi·no·rum

Its leaves contain the extremely potent Salvinorin A. It has a long history of use as spiritual medicine amongst the Macatecs in Mexico. Since the mid 1990s it became widely available and popular despite the fact that its hallucinogenic effects are considered unpleasant by many people.

Syr·i·an rue
PEGANUM HARMALA
Its seeds contain harmine and other harmala alkaloids that act as a MAO-A inhibitor which potentiates and prolongs the effects of other drugs, especially psychedelics. It is one of the plants that is speculated to be the ancient Soma (India) or Haoma (Persia).